1630NO.
y APPL"ICATIOI
;'FEB 28 =1964
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FOR APPLIANCE PERMIT
CITY OF CUPERTINO
FEB 18 1964
Date - - ,.196.....
Permit No. L6,30 ___
a_ r
Fee =
Application is hereby made to the City of Cupertino for a permit to install
gas appliances m listed on the reverse side hereof, and agrees to install said
appliances in accordance with the provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
Use of
RESIDENCE
Owner INLAND EMPIRE DEV.
By MERCURY SHEET METAL
CONTRACTOR, AGENT
Phone 739.422? —?
960 CAMDEN AVE.
Address rANABFLL rAl IF
Address 81 AQCE AVE., MT. VIEW
Approved
Cd
PLUMBING INSPECTOR
Type of Appliance I Units Fees
Remarks (Check ✓)
I New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters I
II I I
Blower Furnaces I� A-0
Gas Fired Boilers I
I
Warming Ovens
II I
Percolators
it I I
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
I I
I
'Miicellineous
II I
o
(NAME TYPE)
rir
I I
II I
I I�
II I
Appliance Fees i5 1�—
Inspected and Approved ....... .1.. <....,_.(�„n_,n. ...
INSPECTOR